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The relationship between bone resorbing factors and loosening after hip prosthetic replacement.

骨吸收因素与髋关节假体置换术后松动的关系

基本信息

批准号：
05671233
负责人：
KUROKI Yoshikatsu
金额：
$ 1.47万
依托单位：
Showa University
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (C)
财政年份：
1993
资助国家：
日本
起止时间：
1993 至 1995
项目状态：
已结题

项目摘要

The progressive enlargement of the radiolucent area has often been observed around the implant, leading to loosening of the prosthesis. The purpose of this study is to elucidate the mechanism of rediolucent area formation. The radiolucent areas could be classified into the linear type and the erosive type, and these two groups were compared as to the histological and biochemical results. The interface membranes were obtained from patients at the time of surgery for revision of either cemented THA or cementless bipolar endprosthetic replacement.The bone resorption around the implant after hip prosthetic replacement occurs in two different pathways. The first pathway may be cnhanccd bone resorption by chemical mediators and enzyme derived from foreigne body granulomas. The second possible pathway would be the bone necrosis by mechanical stresses due to biomechanically unstable implant.Histologically, the interfaces of the osteolysis type contained more debris, macrophages, and giant cell … More s than the linear type. Some macrophages, giant cells and synovial like cells were positively stained with anti-interleukin-6 antibody and TRAP.The levels of IL-6 and IL-8 in the homogenates from osteolysis type were significantly higher than those from the lincar type. The interface membrancs were dissociated by collagenase, and cultured on dentine slices from 2 hours to 1 week in order to study whether the macrophages and giant cells can resorb bone by themselves. Most of coltured cells were stained with NSE of a marker of macrophage, and weren't stained with TRAP at 2 hours. TRAP positive mononucleated and polynucleated giant cells were increased at 1 week, but both of resorption pit and F-actin ring formation weren't observed.According to these findings, macrophages in osteolysis produce IL-6 which activated osteoclast in host bone, and IL-8 which might relate to the formation of foreign body granuloma in addition to the phagocyte of debris. Although some macrophages are stained with TRAP, it might be difficult for macrophages to differentiate to the osteoclast like cells which were capable of bone resorption. Less

在种植体周围经常观察到放射性区域的进行性扩大，导致假体松动。本研究的目的是阐明辐射区的形成机制。放射性显影区可分为线状型和糜烂型，并对两组进行组织学和生化结果的比较。界面膜取自骨水泥型全髋关节置换术和非骨水泥型双极人工关节置换术的患者，人工关节置换术后植入物周围的骨吸收发生在两个不同的途径。第一条途径可能是由肉芽肿产生的化学介质和酶引起的骨吸收增加。第二种可能的途径是由于生物力学不稳定导致的机械应力引起的骨坏死，组织学上，骨溶解型界面含有更多的碎片、巨噬细胞和巨细胞 ...更多信息比线性类型。部分巨噬细胞、巨细胞和滑膜样细胞抗IL-6抗体和TRAP染色阳性，骨溶解型的IL-6和IL-8水平明显高于lincar型。用胶原酶分离界面膜，在牙本质切片上培养2小时至1周，观察巨噬细胞和巨细胞是否具有自行吸收骨的能力。培养2 h后，大部分细胞被巨噬细胞标记物NSE染色，TRAP染色不明显。1周时TRAP阳性单核和多核巨细胞增多，但未见骨吸收陷窝和F-actin环形成，提示溶骨过程中巨噬细胞产生IL-6，激活宿主骨内破骨细胞，产生IL-8，可能与异物肉芽肿的形成有关。尽管一些巨噬细胞被TRAP染色，但巨噬细胞可能难以分化为具有骨吸收能力的破骨细胞样细胞。少